汉川市两流域不同防治措施控制血吸虫病效果比较

目的 目的 比较以传染源控制为主的综合防治措施与常规卫生血防措施控制血吸虫病的效果, 为制定下一步血吸虫 病防治策略提供参考依据。方法 方法 在汉川市南支河流域实施常规卫生血防措施, 在汉北河流域实施常规卫生血防措施的 基础上, 加河滩禁牧、 以机代牛为主并辅以河滩综合开发的措施。采取回顾性调查方法收集2004-2011年汉川市南支河流 域与汉北河流域血吸虫病疫情资料, 比较这两类措施控制两流域血吸虫病的效果。结果 结果 2004年南支河流域人群和耕牛 血吸虫感染率均较汉北河流域低, 2004-2011年南支河流域有螺框出现率和活螺平均密度较汉北河未翻耕种植河滩与防 浪林低; 2004-2011年南支河流域均查获感染性钉螺, 2008-2010年汉北河未翻耕种植河滩未查获感染性钉螺。2007年汉 北河流域耕牛已全部淘汰, 2007-2011年汉北河防浪林未查获感染性钉螺, 南支河流域每年均有粪检阳性耕牛。 2004-2011年两流域人群血吸虫感染率呈逐年下降趋势, 但汉北河流域人群血吸虫感染率下降率较南支河流域更为显 著。 结论 结论 常规血防措施和以传染源控制为主的综合防治措施均可取得较好的血吸虫病防治效果, 但以传染源控制为主 的综合防治措施取得的效果更好。     

汉北河工程灭螺后钉螺分布的调查

汉北河河滩冬陆夏水水位不能控制,并有钉螺孳生。1994年实施疏通堤套挖北河、拓宽主航道扩南河、抬高和就地平整河滩水利灭螺,形成“两堤两河夹一滩”。为了解工程后钉螺分布规律,我们于工程前后对汉北河六孔闸断面进行了调查。调查方法分别于1994、1995年4月对六孔闸汉北河断面内堤坡、南北防浪林、河滩、堤套等环境按10m设框、20m设线系统抽样方法查螺,每框面积0.11m2,分环境高程统计并作钉螺分布类型拟合。调查结果1　钉螺分布环境见表1。工程后河滩占有螺面积的94.65%,活螺框出现率、活螺密度河滩显著高于南防浪林(P均<0.001),而感染螺…     

汉北河滩钉螺纵向观察

为消灭河滩钉螺制定对策,于1981～1986年选择汉北河滩应城市王台村段面进行了钉螺纵向观察。 一、观察方法 汉北河滩王台村段面的防浪林、堤套、草滩、沟渠等四类环境均有钉螺分布。1981～1986年每年4～5月汛期前采取系统抽样结合环境抽查的方法查清各类环境的钉螺的分布情况.计算有螺面积。1983年用五氯酚钠对防浪林、草滩、     

湖沼型血吸虫病流行区实施以机代牛和封洲禁牧措施效果

目的 目的 分析以机代牛和封洲禁牧措施在湖沼型血吸虫病流行区的防治效果。 方法 方法 选择实施以机代牛措施 为主的湖北省江陵县和公安县、 实施封洲禁牧措施为主的湖南省沅江市和华容县, 采用回顾性调查和现场调查方法, 对 2007-2013年人群、 耕牛、 野粪和钉螺感染血吸虫情况进行分析, 比较措施实施前后的防治效果。 结果 结果 湖北省6个行 政村实施以机代牛为主措施, 湖南省7个行政村实施封洲禁牧为主措施。2007-2013年调查村人群血吸虫感染率呈整体 下降趋势, 从3.95%下降至0.69%, 下降了82.53%, 差异有统计学意义 （χ2 = 128.376, P ＜ 0.05）; 以机代牛和封洲禁牧2 组村人群血吸虫感染率下降幅度分别为83.08%和81.62%, 差异无统计学意义 （χ2 = 0.132, P ＞ 0.05）。耕牛血吸虫感染 率从3.66%降至0.65%, 下降了82.24%, 差异有统计学意义 （χ2 = 13.692, P ＜ 0.05）。2013年13个村有螺环境野粪调查 157.44 hm2 , 检获野粪625份, 均为牛粪, 平均密度为3.97份/hm2 , 血吸虫卵阳性7份, 阳性率为1.12%。2007年后, 13个村 钉螺血吸虫感染率和感染性钉螺密度均逐步下降, 2011-2013年均未查到感染性钉螺。 结论 结论 湖沼型血吸虫病流行区 实施以机代牛和封洲禁牧措施控制血吸虫病效果明显。     

耕牛轮牧对控制草洲感染性钉螺效果的研究

目的：探索耕牛轮牧对控制草洲感染性钉螺的效果。方法：选择翻阳湖中,重度疫区进贤县的军山湖乡为实验区,将该乡草洲划分为耕牛放牧区和禁牧区,每隔1两区轮换,耕牛进入放牧区前普治1次,同时,选择三里乡丰富行政村为对照区,耕牛敞放于草洲,每年普治1次,结果：实施安全轮牧的9块有螺草洲中,试前3块无感染螺,度后连续2年亦未发现感染螺,试前6块有感染螺的草洲,试后2年4块草洲感染性钉螺逐年下降到0,另外2块距村较近的]草洲仍有感染螺,感染螺放面下降了84．90％,耕牛感染率亦下降81．115,对照区6块草洲,试后2年感染螺面积下降20．83％,感染螺面积占有螺划洲面积的71．60％,耕牛感染率下降不显著,结论：草洲耕牛实施轮牧能有效地控制感染性钉螺密度,但离村较近草洲耕牛难以实施禁牧,感染螺密度得不到有效的控制。     

以河滩为中心的牛群化疗加机耕控制感染性钉螺的观察

在难以开展药物灭螺的河滩地区,为控制其感染性钉螺,减少血吸虫再感染,１９９４年起以汉北河应城市义和段河滩为中心,平行实施了牛群化疗和河滩机耕,取得了降低感染性钉螺的满意效果。方法现场概况选择的汉北河应城市义和段河滩面积为７３６０００ｍ２（２３００ｍ×...     

2007年湖北省血吸虫病监测点钉螺监测结果分析

目的了解湖北省钉螺和感染性钉螺分布特点与规律。方法按照湖北省血吸虫病监测方案的要求,在全省血吸虫病流行区选择有代表性的74个流行村作为监测点,采用系统抽样结合环境抽样的方法,对监测点开展钉螺和感染性钉螺分布情况监测。结果74个监测点活螺密度、感染螺密度和钉螺感染率分别为0.474、0.000 51只/0.1 m~2和0.107%。垸内型监测村、河道和防浪林的活螺密度分别为0.784、0.738和0.673只/0.1 m~2,河道的感染螺平均密度为0.003 36只/0.1 m~2。在9个血吸虫病传播控制监测点中,有2个点查出了感染性钉螺。结论钉螺疫情比2006年下降,但垸内型监测村、河道和防浪林的活螺平均密度、河道的感染螺平均密度仍较高。应该加强重点地带钉螺,尤其是感染性钉螺的控制工作。     

2005～2007年进贤县金红村血吸虫病疫情监测

目的观察2005～2007年进贤县金红村血吸虫病监测点疫情变化,为科学制定此类疫区防治对策提供依据。方法按照《全国血吸虫病监测方案》和《江西省血吸虫病国家级监测点实施方案》,调查人群和家畜血吸虫病病情、洲滩螺情和血吸虫病防治措施。结果金红村实施健康教育结合人群化疗和易感环境灭螺综合防治措施,2005～2007年人群血吸虫感染率分别为5.22%、0、0;耕牛血吸虫感染率分别为3.33%、5.63%、2.35%;洲滩感染螺密度分别为0.0058、0.0045、0.0039只/0.1m2。结论金红村监测点3年人群血吸虫感染率显著下降,但洲滩感染螺密度和耕牛血吸虫感染率均处较高水平,应加大易感环境灭螺和控制传染源工作力度。     

不灭钉螺(封洲禁牧)控制大湖洲滩血吸虫病的研究

目的 探讨通过“封洲禁牧”,达到有螺无害,从而控制大湖洲滩血吸虫病的流行。方法 每年3月1日至10月31F{洲滩实施“封洲禁牧”,并查治人、畜血吸虫病。结果 实施3年(2000—2002),监测点(村)人群感染率由1999年的2．66％下降到1．66％,试点乡抽查人群感染率为0．57％(5／871),无急性感染和新感染病人。试点乡耕牛血吸虫感染率由1999年的4．90％下降到0．14％,2岁以下小牛无新感染。草洲钉螺阳性率由1．450％下降到0．005％,阳性钉螺密度由0．01480只／0．1m^2下降到0．00011只／0．1m^2。结论 采取以“封洲禁牧”为主的综合措施,不灭钉螺也可以控制大湖洲滩血吸虫病的流行。     

安徽省池州市贵池区实施以传染源控制为主的血吸虫病综合防治策略效果评价

目的评价以传染源控制为主的血吸虫病综合防治策略在湖沼型地区的防治效果。方法2006～2008年,分年度在安徽省池州市贵池区秋浦河流域,长江、九华河流域,以及升金湖流域实施以传染源控制为主的血吸虫病综合防治策略,在以上流域的40个流行村中随机抽取13个流行村,观察综合防治策略实施前后病情和螺情变化,评价综合防治策略效果。结果2008年秋浦河流域人群平均血吸虫感染率、感染性钉螺密度和钉螺感染率较综合防治策略实施前的2005年分别下降了68.60%、96.00%和96.00%;长江、九华河流域人群平均血吸虫感染率、感染性钉螺密度和钉螺感染率较综合防治策略实施前的2006年分别下降了51.55%、71.15%和68.97%;升金湖流域人群血吸虫平均感染率、感染性钉螺密度和钉螺感染率较综合防治策略实施前的2007年分别下降了49.58%、73.58%和51.78%。综合防治策略实施后,以上流域急性血吸虫病病例明显减少。结论在湖沼型地区实施以传染源控制为主的综合防治策略能有效控制血吸虫病疫情。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

治疗高血压药物的经济学评价

重视高血压治疗中的经济学评价,对利用我国有限的卫生资源来遏制高血压对人民群众的危害有着重要的现实意义。药物经济学对于药物治疗的成本和治疗的结果给予同样的关注。因为治疗高血压的费用,不仅涉及药物价格,还包括患者的危险水平,降压疗效和对临床终点事件的影响,以及治疗的依从性和安全性。因此药物经济学更强调整体成本和价-效比。低危病人,若非药价低廉,治疗的价-效比不够理想。而在高危的患者,价-效比越小越经济而不是药费越便宜越好。